Remittance Advice Notices

60.8.1 – Remittance Advice Notices (Rev. 2998, Issued: 07-25-14, Effective: Upon implementation of ICD-10; 01-01-12 - ASC X12, Implementation: 08-25-2014 - ASC X12; Upon Implementation of ICD-10) Use appropriate existing remittance advice reason and remark codes at the line level to express the specific reason for denying payment for PT/INR: Remittance Advice Remark Code N386, “This decision was based on a National Coverage Determination (NCD). An NCD provides a coverage determination as to whether a particular item or service is covered. A copy of this policy is available at http://www.cms.hhs.gov/mcd/search.asp. If you do not have Web access, you may contact the contractor to request a copy of the NCD.” If denying services furnished after July 1, 2002, use ASC X 12-835 claim adjustment reason code 50, “These are non- covered services because this is not deemed a ‘medical necessity’ by the payer.”